Wiki Global Billing vs Problem Visits

[cortneyfigurell]

We have 2 OBGYN Doctors and 2 Family Nurse Practitioners. Our FNPs will see OB patients for sick visits that are unrelated to pregnancy (flu, strep, ear ache, ect)

How exactly does the billing work in this situation? We have tried multiple ways but if we bill the e/m out from the sick visit, after the delivery is billed, the claim is reprocessed and gets denied and when appealing, they still dont get covered.

Does anyone have any insight for this type of situation?

Thank you!

 

[mitchellde]

we have always use the 24 modifier on the sick visit , for the dx we use the O code first with the specific issue second.. such as URI we code the O99.51- followed by the J06.9 then the Z3a.- .
Most payers will allow the use of the 24 modifier to separate a sick visit from the OB global.

 

[cortneyfigurell]

we have always use the 24 modifier on the sick visit , for the dx we use the O code first with the specific issue second.. such as URI we code the O99.51- followed by the J06.9 then the Z3a.- .
Most payers will allow the use of the 24 modifier to separate a sick visit from the OB global.

Are you billing the sick visits after delivery or at the time of service? We are getting them paid at the time of service. But they get recouped after delivery is billed.

 

[Countrycoder19]

We add the 24 mod and bill at the time of service. So far we have not had any problems with them.